HCV AND GUILLIAN-BARRE SYNDROME- A RARE ASSOCIATION

Case report: We report a case of thirty year old female, not a known case of any chronic illness, recently diagnosed to be having Chronic hepatitis C virus (HCV) infection, presented with acute onset of gradually progressive ascending flaccid paralysis of three days duration. Her HCV viral load was low 2645 I.U./ml and liver function tests were essentially normal. She was non-cirrhotic with normal Fibroscan score of 7 Kpa. At the time of admission, she was conscious, oriented, afebrile but was unable to move all four limbs on her own. Her Nerve conduction studies were suggestive of Guillain-Barré syndrome (GBS). She developed fever and vomiting within six hours of admission, along with features of autonomic dysfunction and involvement of respiratory muscles. Hence was urgently shifted in Intensive care unit (ICU) and was put on ventilatory support. She succumbed to her illness within few hours of stay in ICU, before treatment with Intravenous immunoglobulins or plasmapheresis could be started.

Conclusion:  Our case report is an unusual case of GBS in a recently diagnosed young non-cirrhotic HCV patient who had a rapid catastrophic course and died within few days of diagnosis of HCV infection. There is limited case reports of GBS with HCV infection, hence should always be kept in differential diagnosis whenever patient presents with lower limb weakness. Early diagnosis and timely initiation of treatment is crucial to treat GBS.